SSA-536 Supporting Statement--120908 REVISED

Supporting Statement for Form SSA-536,

Medical or Psychological Consultant’s Review

Of Childhood Disability Evaluation Form

20 CFR 416.1040, 416.1043, 416.1045, and 416.924(g)

OMB # 0960-0675

A. Justification

1. In accordance with 20 CFR 416.1040, 416.1043, and 416.1045 of the Code of Federal Regulations, the Social Security Administration (SSA) measures the performance of Disability Determination Services (DDSs) in the area of quality of documentation and determinations on claims. Section 221(c) of the Social Security Act (the Act) requires that SSA review state agency performance in individual cases and classes of cases. To assure effective and uniform administration of SSA’s disability program, standards are applied. In accordance with 20 CFR 416.924(g), DDSs administering the Title XVI (Supplemental Security Insurance) program are required to complete a standard form, Form SSA-538 (Childhood Disability Evaluation Form, OMB No. 0960-0568) to explain their findings when making an initial or reconsidered determination whether a child is disabled or whether his or her disability continues. Section 1633(a) of the Act provides that the Commissioner of Social Security may make arrangements as appropriate to carry out any administrative functions as necessary.

2. SSA’s regional review component uses Form SSA-536 to facilitate the contract medical or psychological consultant’s review of the Childhood Disability Evaluation Form. The form records the reviewing consultant’s assessment of the evaluation prepared by the adjudicating component. The consultant completes an SSA-536 for each Title XVI childhood disability case he or she reviews because a Childhood Disability Evaluation Form is required in each case. Respondents are consultants who review the adjudicating component’s completion of the Childhood Disability Evaluation Form.

2. Form SSA-536 is available as an eForm, which is accessible through the Disability Case Adjudication and Review System (DICARS). DICARS is only accessible to the Disability Quality Branches for the purpose of adjudication and review of disability cases. Thus, the DICARS version of the Form mirrors the paper version; however, within DICARS, the respondents fill out and send the Form electronically. DICARS allows the respondents to choose to sign electronically. The respondents submit at least 80 percent of the reviews electronically.

2. The nature of the information we are collecting and the manner in which we are collecting it preclude duplication. SSA does not use another collection instrument to collect similar data.

2. This collection does not affect small businesses or other small entities.

2. If SSA did not collect this information, reviewing medical or psychological consultants would have an increased burden of recording the review in free form narrative. In addition, collection of this information is mandatory by law; therefore, we cannot collect it less frequently. There are no technical or legal obstacles that prevent burden reduction.

2. There are no special circumstances that would cause SSA to conduct this information collection in a manner inconsistent with 5 CFR 1320.5.

2. The 60-day advance Federal Register Notice published on February 25, 2009, at 74 FR 8607, and SSA received no public comments. The second Notice published on April 28, 2009, at 74 FR 1961. SSA did not consult members of the public in the development of this form.

9. SSA provides no payment or gifts to the respondents.

10. SSA protects and holds confidential the information it is requesting in accordance with 42 U.S.C. 1306, 20 CFR 401 and 402, 5 U.S.C. 552 (Freedom of Information Act), 5 U.S.C. 552a (Privacy Act of 1974), and OMB Circular No. A-130.

10. The information collection does not contain any questions of a sensitive nature.

10. Approximately 256 respondents use form SSA-536 annually. The estimated average response time is 12 minutes, for 3,379 burden hours. The total burden represents burden hours, and SSA did not calculate a separate cost burden. The estimated numbers of respondents and burden hours have not changed.

10. There is no known cost burden to the respondents.

10. The annual cost to the Federal Government is approximately $52,360.00. This estimate is a projection of the costs for printing and distributing the collection instrument and for collecting the information.

10. Prior to ROCIS, we rounded the numbers up to 17,000. However, since ROCIS does not round the numbers in the same way, we are using the ROCIS calculations at this time. The estimated numbers of respondents and burden hours have not changed.

10. SSA will not publish the results of the information collection.

10. OMB exempted SSA from the requirement to print the OMB approval expiration date on its program forms. SSA produces millions of public-use forms, many of which have a life cycle longer than that of an OMB approval. SSA does not periodically revise and reprint its public-use forms (e.g., on an annual basis). OMB granted this exemption so the agency would not have to discontinue using otherwise useable editions of forms with outdated expiration dates. In addition, SSA avoids Government waste, because we will not have to destroy and reprint stocks of forms.

10. SSA is not requesting an exception to the certification requirements at 5 CFR 1320.9 and related provisions at 5 CFR 1320.8(b)(3).

B. Collection of Information Employing Statistical Methods

SSA is not using statistical methods for this collection.